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Damage accrual in Behçet disease: Behçet's Syndrome Overall Damage Index (BODI) versus Behçet's Disease Damage Index
Rofaida A Hassan1, Enas I Abdelhady1, Mona Rabie1
1Rheumatology & Rehabilitation Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Insights
Behçet
Area of Science:
- Rheumatology and immunology
- Clinical assessment tools
- Systemic vasculitis research
Background:
- Behçet's disease (BD) is a complex systemic vasculitis.
- Accurate assessment of disease damage is crucial for patient management.
- Existing damage indices require validation for their effectiveness.
Purpose of the Study:
- To evaluate the validity of Behçet's Syndrome Overall Damage Index (BODI) and Behçet's Disease Damage Index (BDI) in detecting damage accrual in BD patients.
- To compare BODI and BDI against the Vasculitis Damage Index (VDI).
- To assess the correlation and consistency among VDI, BODI, and BDI.
Main Methods:
- A prospective cohort study involving 102 adult BD patients.
- Diagnosis confirmed using International Study Group criteria.
- Disease severity and organ damage assessed using VDI, BDI, and BODI at baseline and 1-year follow-up.
- Damage accrual defined as an increase of ≥1 point in an index.
Main Results:
- All three indices (VDI, BODI, BDI) showed significant correlations with each other (r > 0.835, P < 0.001).
- Strong positive correlations were observed between the indices and age/disease duration.
- The Behçet's Disease Current Activity Form showed non-significant correlation, indicating good discriminative validity.
- The Behçet's Disease Damage Index (BDI) demonstrated higher sensitivity than BODI in detecting damage accrual and better agreement with VDI.
Conclusions:
- The Vasculitis Damage Index (VDI), Behçet's Syndrome Overall Damage Index (BODI), and Behçet's Disease Damage Index (BDI) exhibit good convergent and discriminative validity for assessing Behçet's disease damage.
- The Behçet's Disease Damage Index (BDI) is more sensitive than BODI for detecting damage accrual in Behçet's disease patients.
Objectives:
To assess the validity of Behçet's Syndrome Overall Damage Index (BODI) and Behçet's Disease Damage Index (BDI) as tools for the detection of damage accrual in Behçet's patients compared to Vasculitis Damage Index (VDI). Also, to evaluate the correlation and the interclass correlation among the 3 indices to find out their consistency.
Method:
A prospective cohort study was carried out on 102 adult Behçet's disease (BD) patients who were diagnosed according to the International Study Group criteria for BD. Disease severity and organ damage were assessed for each patient by VDI, BDI and BODI at baseline and 1-year follow-up visits. Damage accrual for each index was defined when there was an increase of at least 1 point (∆ ≥ 1) among the baseline and the follow-up visits.
Results:
Correlations among the 3 indices were significant, with (r = 0.835, P < 0.001) between VDI and BODI, (r = 0.835, P < 0.001) between VDI and BDI, and (r = 0.844, P < 0.001) between BODI and BDI scores. A highly significant positive correlation existed between the 3 indices and age and disease duration. In contrast, the correlation with the BD Current Activity Form was non-significant, which indicates good discriminative validity of the 3 indices. Neuropsychiatric and ocular systems showed a strong interclass correlation among the 3 indices. Regarding detecting damage accrual, BDI was more sensitive than BODI and showed more agreement with VDI.
Conclusion:
BD damage indices, VDI, BODI and BDI, had good convergent and discriminative validity for the assessment of BD damage. BDI had more sensitivity than BODI to the detection of damage accrual.
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